Q. What are the ingredients of the anti-viral medications?
A. Relenza contains lactose (dairy protein) and Tamiflu contains corn starch and gelatin, which are allergens for some people. See the full list of ingredients here.

Q. Will the new H1N1 vaccine contain egg?
A. The H1N1 vaccine for Canada is being developed by GlaxoSmithKline using the egg-based production method. This means the vaccine viruses are grown in eggs. This is true for the regular flu shot as well.

If you are allergic to egg, Dr. Wade Watson advises to speak with your allergist about the possibility of being skin-tested to the vaccine. The vaccine should always be given under observation, regardless of a previous history of allergic reaction.

DS is allergic to both dairy and egg so he can't get the Relenza vaccine because of the lactose. The ingredients for Tamiflu are safe, but is it made in eggs? I can't find which vaccine GlaxoSmithKline is making, Relenza or Tamiflu (or both?). Is there a vaccine that does not contain dairy and is not made in eggs?

It can get confusing (I learn such weird things from dd's allergies!)! There are basically two different options:
1. Get vaccinated with the H1N1 vaccineIngredients: Suspension for Injection -
15 μg influenza virus Hemagglutinin/strain/ 0.5 mL dose
Thimerosal, trace amounts of egg proteins, formaldehyde, sodium deoxycholate and sucrose

Quote:

FLUVIRAL® is a trivalent, split-virion influenza vaccine prepared from virus grown in the allantoic cavity of embryonated hens' eggs. The virus is inactivated with ultraviolet light treatment followed by formaldehyde treatment, purified by centrifugation and disrupted with sodium deoxycholate. FLUVIRAL® is used for active immunization against influenza disease caused by the influenza subtypes A and type B contained in the vaccine.
FLUVIRAL® conforms to the current requirements of the World Health Organization (WHO). The influenza virus stains for the 2008-2009 season are A/Brisbane/59/2007 (H1N1)-like strain (A/Brisbane/59/2007 IVR-148), A/Brisbane/10/2007 (H3N2)-like strain (A/Uruguay/716/2007 NYMC X-175C) and B/Florida/4/2006-like strain (B/Florida/4/2006).

2. Do not get vaccinated and if you contract the flu, treat it with an anti-viral of which there are two.Relenza - an oral inhaler
Ingredients: Dry powder 5 mg/blister and lactose
RELENZA® is not recommended for treatment or prophylaxis of influenza in individuals
with underlying airways disease (such as asthma or chronic obstructive pulmonary
disease [see WARNINGS AND PRECAUTIONS]) due to risk of serious bronchospasm.

So what should you do? Probably the best course of action is to avoid getting the flu and if you don't have allergies to egg and are otherwise healthy the H1N1 vaccine should be fine. If you have an egg allergy talk to your allergist. If it is a mild allergy you may still be able to tolerate this vaccine.

If you have can't have the vaccine and also have asthma, COPD, or allergies to any of the ingredients in the anti-viruses, you definately need to discuss your options with your allergist or attending physician.

My husband and I will get vaccinated but if our daughter gets the flu we will most likely have to use the Tamiflu anti-viral.

Thanks Susan, I totally misunderstood. I though Relenza and Tamiflu were options for the H1N1 vaccine. I didn't realize it was actually a different vaccine altogether and that Relenza and Tamiflu are only given after you have the flu.
Is Tamiflu made in eggs, and is it available in Canada?

From what I've read, there doesn't seem to be any egg in Tamiflu and yes, it should be available in Canada. On Health Canada's website they discuss Tamiflu and Relenza so I would assume that they will both be available.

Diana, I'm glad you're following now. Perhaps you missed this part at the top of Claire's article, which explains that the new vaccine is not yet ready, and that the drugs available at the moment are Relenza and Tamiflu (which are not vaccines):

Quote:

A vaccine against H1N1 is in clinical tests and is expected to be available in Canada by November, with 3.5 million doses available each week. PHAC hasn't yet determined exactly who will have access to the vaccine first.

In the meantime, a doctor may prescribe an anti-viral medication if you contract the flu, to reduce your symptoms. Or it might be prescribed as a “prophylaxis”, which means, to reduce the likelihood that you will contract the virus. (This would likely be to stop the spread of the flu in a setting such as a hospital.)

I've read that the H1N1 vaccine will be available in Canada in Nov (or sooner) but DS cannot get the vaccine because of his egg allergy. Because of DS's history of flu and croup (I think he had it about 8 times last winter) and his virus induced asthma, I am very concerned that if he is exposed to H1N1 (and being in day care I am pretty sure it will happen) he will get a bad case of it. He cannot get the Relenza anti-virus but can have Tamiflu. Which has got me thinking. Is the Tamiflu available now? Is there a chance they will run out of Tamiflu? Is it possible to ask our doctor for a prescription for it now, in case he gets a suspected case later? It would make me feel so much better having it in the house that I can give him if I see symptoms of H1N1, and not take the risk of needing it and find out only Relenza is available. I read on another forum where one child got the virus and the doctors will give him Tamiflu and any other kids in the house also as a preventative measure. That was in the US, but I think I'm kind of liking that idea. If one kid at day care gets it, and we can start DS on Tamiflu before symptoms even start then hopefully it would not progress too far.

Diana,
My dad caught the H1N1 while we were on a cruise this summer. My mom, my brother and I were also given Tamiflu. My mom took it because she was in a cabin with him, my brother and I held on to it. You should only take Tamiflu if you have the symptoms (in my mom's case, they were trying to prevent spread to other passengers but they were confined to their room anyways). I would definitely try to get some now because they are saying that they won't give it out BUT in you DS' case, he is high risk so I am sure they will give it to you no problem. If he shows the symptoms give it to him right away but don't give it to him unless he does because otherwise when you need it, it won't be there. Just to give you an idea, my mom is not immune or anything just because she took Tamiflu...my dad IS because he caught the virus (as long as the new strain doesn't mutate). So, treat Tamiflu like gold. But don't worry...IT WORKS. Like, really fast too. My dad took it and then next day he felt back to normal but couldn't come out of his room because his cough was lingering which is normal.

_________________Associate Editor at Allergic Living.
Allergies to all nuts and legumes except soy and green beans.

I faxed the CSACI statement to my allergist and he is feeling that given R's level of severity and her asthma, history etc. he is not comfortable giving her the vaccine even in the stages set out. He is very cautious and there isn't enough evidence yet to sway him.

We have an appointment in January so I hope we can just hang in there until then.

Luckily, she is so cautious about contact reactions to allergens that she is great at hand washing!

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